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The colon runs from the caecum, low on the right, to the sigmoid, low on the left. A tumour near its start needs a different robotic operation from one near its end. This page matches each tumour site to its operation, and explains what the robot changes in all of them. Apollo Hospital, Bhat, Gandhinagar · Gota OPD, Ahmedabad.
Last updated: 13-Oct-2026
Dr Harsh Shah
MS, MCh (Surgical Gastroenterology), DrNB (Surgical Gastroenterology)
Robotic Cancer Surgeon (GI)
Apollo Hospital, Bhat, Gandhinagar · Gota OPD, Ahmedabad
★★★★★ Google: 4.9 from 53 reviews (Gota clinic) · 5.0 from 25 reviews (Apollo, Bhat)
Shah’s Gastro, Cancer & Robotic Surgery Centre. Two higher degrees in GI surgery and 18 years of experience in GI and cancer surgery. Every colon cancer goes to the tumour board before treatment. Dr Harsh Shah performs the operation himself.
In short
Where the tumour sits decides which part of the colon is removed. It also decides which blood vessels are tied, because the lymph nodes follow those vessels.
Every robotic colon operation removes the same tissue as keyhole or open surgery. The robot adds a steady 3D view and wristed tools for the deep steps.
Keyhole surgery is the long-tested standard for colon cancer. Robotic surgery is a sound choice in experienced hands. Emergencies and very bulky tumours are usually done open.
The colonoscopy report and the CT scan show where the tumour sits. This table shows the operation our protocol uses for each site, and the page that explains it.
| Where the tumour sits | Operation | Vessels tied at their root | Read more |
|---|---|---|---|
| Caecum or ascending colon. | Right hemicolectomy. | Ileocolic and right colic. | Robotic right hemicolectomy. |
| Hepatic flexure or first part of the transverse colon. | Extended right hemicolectomy. | As above, plus middle colic. | Robotic transverse colon surgery. |
| Far part of the transverse colon, or splenic flexure. | Extended right or left hemicolectomy. | Middle colic, with or without left colic. | Transverse colon or splenic flexure. |
| Descending colon. | Left hemicolectomy. | Left colic. | Robotic left hemicolectomy. |
| Sigmoid colon. | Sigmoid colectomy or anterior resection. | Inferior mesenteric, tied high or low. | Robotic sigmoid colectomy. |
| Rectum, low in the pelvis. | A rectal operation, planned by MRI. | Follows the rectal protocol. | Robotic rectal surgery by height. |
A tumour that cannot be felt during surgery is marked first. A small ink tattoo is placed beside it at colonoscopy. The robot’s camera finds the tattoo and confirms the right segment.
Lymph nodes travel with the blood vessels that feed each part of the colon. To remove the nodes, the vessel is tied where it starts, and its fan of tissue comes away whole.
Each part of the colon has its own main artery. The right colon is fed by the ileocolic artery. The middle is fed by the middle colic. The left side and the sigmoid are fed by branches of the inferior mesenteric artery.
Cancer spreads first to the nodes along these vessels. So the surgeon does not simply cut out the tumour. The whole fan of fatty tissue that holds the vessel and its nodes is removed in one piece.
This is called complete mesocolic excision. A tumour in the transverse colon sits between two vessel systems. That is why it can need an extended right or an extended left operation. The choice is made from the scan and the vessels at surgery.
Whatever the site, our protocol sets the same cancer rules. These rules do not change because a robot is used. They are checked in the tissue report afterwards.
| Rule | What it means for you |
|---|---|
| High tie of the feeding vessel. | The vessel is tied at its origin, so its nodes come out with it. |
| Whole fan of tissue removed. | The tissue around the vessels is lifted off in one intact layer. |
| At least twelve lymph nodes examined. | Fewer than twelve changes the advice on chemotherapy. |
| At least five centimetres of clear bowel each side. | The cut ends are free of cancer. |
| Any stuck organ removed with the tumour. | The tumour is never peeled off a neighbour, because that can leave cancer behind. |
| No spill of tumour cells. | The tumour is handled as little as possible. |
You lie on your back, tilted so the bowel falls away from the area. Four small robotic ports and one assistant port are placed. The robot is then docked beside you.
The four robotic ports are each about eight millimetres wide. They usually sit in a line across the lower abdomen, roughly eight centimetres apart. This spacing stops the arms from clashing.
The assistant port is a little larger. A bedside surgeon uses it for staplers, suction and clips. The camera goes through one of the robotic ports.
The direction of docking is planned before the first cut. For a right-sided tumour, the robot is aimed towards the right upper abdomen. For a left-sided or sigmoid tumour, the set-up is a mirror image.
The robot’s boom can turn to a new target without undocking. This helps when a tumour sits near a bend of the colon. Moving the camera between ports takes moments.
| Step | Right side | Left side and sigmoid |
|---|---|---|
| Main area of work. | Around the duodenum and the head of the pancreas. | Around the aorta, the left ureter and the pelvis brim. |
| Main vessels tied. | Ileocolic, right colic, and sometimes middle colic. | Inferior mesenteric or its left colic branch. |
| Port line. | Across the lower abdomen. | A mirror image of the right side. |
| Common extra step. | Care with the large vein below the pancreas. | Freeing the bend near the spleen when more length is needed. |
The robot does not remove more or less colon. It changes how the surgeon reaches the deep, narrow parts: the root of each vessel and the planes behind the bowel.
Behind the colon lies a natural tissue plane. The colon and its fan of nodes can be lifted off the back wall along it. The ureter and other important structures lie just behind this plane.
The robot’s camera is held steady by the machine. It is magnified and in 3D. The surgeon sees the thin layer between the fan of nodes and the structures behind it.
The wristed tools bend like a hand. They can work around the curve of a vessel at its origin. Straight keyhole tools reach the same place, but at a fixed angle.
On the right side, the vessels end close to the large veins below the pancreas. These veins are thin-walled and short. A steady view helps the surgeon control them.
After the segment is removed, the two ends are joined. Depending on the site and your build, the join can be made inside or outside the abdomen.
In a joint made outside, the bowel is brought out through a small cut and joined there. In a join made inside, the robot staples and stitches the ends inside the abdomen. The specimen then comes out through a small cut low on the abdomen.
Wristed tools make stitching inside the abdomen easier, especially in a heavier patient with a short bowel fan. Your surgeon decides which suits your operation at the time.
Before or after the join, a dye can be given into a vein. Under the robot’s camera, bowel with good blood flow glows. This helps the surgeon choose a well-supplied place for the join.
All three approaches follow the same cancer rules and remove the same nodes. They differ in the cuts, blood loss, hospital stay, return to work and cost.
| Open | Keyhole | Robotic | |
|---|---|---|---|
| Cuts. | One long cut on the abdomen. | Small ports and one short cut. | Small ports and one short cut. |
| Blood loss. | More. | Less. | Less. |
| View. | Direct. | Magnified, flat, held by an assistant. | Magnified, 3D, held steady by the robot. |
| Tools. | Hands. | Straight. | Wristed. |
| Lymph nodes removed. | The same. | The same. | The same. |
| Join made inside the abdomen. | Not used. | Possible, but harder. | Easier to stitch. |
| Hospital stay. | Longest. | Shorter. | Shorter. |
| Return to work. | Later. | Sooner. | Sooner. |
| Long-term evidence for colon cancer. | Longest record. | Proven equal to open. | Newer, used in experienced hands. |
| Cost. | Lowest. | A little higher. | Highest, for the robotic tools. |
Our protocol is honest about this. For colon cancer, keyhole surgery is the validated standard. Robotic surgery is a sound choice when the team is experienced. The figures for your own operation are given at the consent visit.
A blocked or burst bowel needs an urgent plan, not a planned robotic list. Very bulky tumours and a scarred abdomen are usually done open.
| Situation | Usual plan |
|---|---|
| Blocked bowel on the right side. | An urgent operation, and the ends are usually joined at once. |
| Blocked bowel on the left side, fit patient. | An urgent operation. A join, sometimes protected by a stoma, or a stoma alone if unsafe. |
| Blocked bowel on the left side, unfit or with spread. | A metal stent through a scope to open the bowel. A planned operation can follow later. |
| A burst bowel at the tumour. | An urgent operation, washout, and usually a stoma. |
| A bulky tumour stuck to other organs. | Planned at the tumour board. Often open, removing the organs together. |
| Many past operations with dense scarring. | Open surgery is often safer. |
| Unclear plane or bleeding during surgery. | Change to open. |
Changing to open during a robotic operation is a safety decision, not a failure. Your surgeon explains this possibility before consent.
Preparation is the same for robotic and keyhole surgery. Bowel cleansing with antibiotic tablets, better blood counts and good blood sugar all lower the risk of infection.
Low iron is corrected first, by tablets or a drip. Smoking and alcohol stop at least four weeks before. If you are underweight or very weak, a dietitian and an exercise plan come first.
The day before, you take a bowel cleansing drink with antibiotic tablets. In the evening, and two hours before surgery, you drink a carbohydrate drink. This is skipped if the bowel is blocked.
If a stoma is at all possible, a stoma nurse marks a suitable site on your abdomen. A stoma is discussed at consent every time, even when it is unlikely.
Most people sit out of bed on the day of surgery and eat the next day. After an uncomplicated operation, many go home on the fourth or fifth day.
| When | What happens |
|---|---|
| Day of surgery. | Out of bed two hours after waking. Clear fluids. Chewing gum. Drip stopped once you drink. |
| Next day. | Normal food as you can. Walking four times. Urine tube out. |
| Second day. | Full diet. Walking four to six times. Pain tablets only. |
| Third day. | Bowels usually open. Checks before going home. |
| Fourth or fifth day. | Home, after an uncomplicated operation. |
Some signs need the team the same day. These are fever, a fast pulse, new or worse pain in the abdomen, or failing to move forward after the third day.
Walking starts at once and increases daily. Blood-thinning injections continue for four weeks. Work returns in stages, set at your follow-up visit.
The small cuts heal quickly. Avoid heavy lifting until your surgeon advises, because the abdominal wall needs time.
Your bowel habit may change after a colon operation. The team advises you on this at each follow-up visit. If you have a stoma, the stoma nurse trains you or a family member before discharge.
Desk work usually returns before heavy work. There is no fixed calendar. Your own return date is set at the follow-up visits.
The tissue report is discussed at two weeks. Its four key items decide whether chemotherapy is advised, and for how long. Follow-up then runs for five years.
| Report or time | What follows |
|---|---|
| Stage I. | No chemotherapy. Follow-up only. |
| Stage II, no high-risk feature. | Usually no chemotherapy. Follow-up. |
| Stage II with a high-risk feature. | Chemotherapy is discussed with you. |
| Stage III. | Chemotherapy for three or six months, starting within six to eight weeks. |
| Every three months for three years. | Examination and a CEA blood test. |
| One year after surgery. | Colonoscopy. Then at three years, and every five years. |
★★★★★
“Excellent doctor for stomach cancer. We r very happy. Recommend for gastro cancer treatment in Ahmedabad”
Purshottam Meena · Google review
★★★★★
“I had a truly positive experience with Dr. Harsh Shah. He is not only highly knowledgeable but also very compassionate and patient in explaining every detail. I underwent CRS HIPEC surgery under his care, and I couldn’t have asked for a better doctor. The entire process was smooth, and his expertise made a complex procedure feel manageable. Post-surgery recovery was well-monitored, and he was always available for any concerns. Highly recommend Dr. Harsh Shah for anyone needing advanced surgical oncology care.”
Akram Khan · Google review
★★★★★
“Dr harsh operated my sister for liver cancer .we came for follow up .Now she is good. Thank u so much sir”
Natu Vadalia · Google review
Quoted exactly as written on the centre’s Google listings: a stomach cancer patient’s family, and two patients of Dr Harsh Shah treated for other cancers. The one review here that names colon cancer uses a word this page keeps out, so it is not shown. Below them, a patient speaks after a colon cancer operation.
A robotic colectomy costs more than a keyhole one, because of the robotic tools. A stoma, a longer stay or a complication changes the total.
The office prepares a written estimate once the operation is decided. Cashless admission is arranged at Apollo Hospital, Bhat when your policy allows it. Allow a day or two for robotic approval. Ask whether your policy covers robotic surgery, and up to what limit. Bring the policy papers, photo identity, all reports with scans on disc, and your medicine list. You can also call the office on +91-63590-11009 before you travel.
It depends on where the tumour sits. The table on this page matches each site of the colon to its operation.
No. Both remove the same bowel and nodes under the same rules. The robot changes the view and the tools.
Keyhole surgery is the validated standard. Robotic surgery is a sound choice in experienced hands, and is easier for stitching inside.
Most planned colon operations join the bowel without one. A stoma is more likely in an emergency, and is discussed at every consent.
A blocked or burst bowel needs an urgent plan. Sometimes a stent opens the bowel first, so a planned operation can follow.
After an uncomplicated operation, many people go home on the fourth or fifth day.
Shah’s Gastro, Cancer & Robotic Surgery Centre, Gota, Ahmedabad
Consultation, review of scans and pathology reports, second opinions, follow-up and surveillance.
Google: 4.9 · 53 reviews
Apollo Hospital, Bhat, Gandhinagar
Admission, robotic and open surgery, and inpatient care.
Google: 5.0 · 25 reviews
Patients travel for colon cancer surgery from across Gujarat, southern Rajasthan and western Madhya Pradesh.
Send the colonoscopy and biopsy reports, the CT report and the CEA result ahead of your appointment, so the consultation starts with them already read. Whether surgery suits you, and which operation, are decided at the consultation after examination, and by the tumour board. Call +91-63590-11009 WhatsApp the office
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